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What consenting adults do with their body is their own business.
Bodily autonomy is an all or nothing thing. Whether you're talking about abortion, gender affirming surgery, taking a dick in the ass and in the mouth at the same time, or shooting meth into your dick. It's all the same thing.
I don't necessarily disagree, but this brings up the next round of tough questions:
If your bodily autonomy is absolute, fine, but what happens when your choices and their impact start to spill beyond your own personal life?
If you want to go wild with hard drugs, okay fine, whatever. But when you need medical attention because of that decision, should insurance providers or the state be obligated to spend in order to treat you?
When your addiction costs you your job and support network, should the collective taxpayer have to subsidize your poor life choices?
I don't mind the notion that individuals should have final say over what happens to their bodies, but that sort of assumption of responsibility, at some point, cuts both ways...and the flip side of some of these decisions would suggest that the individual should bear all consequences of their decisions...which seems unlikely in practice. We're not going to see an addict rushed to an ER and the hospital toss them out into the street saying, "This was your decision! Sorry!"
And the mitigation measures seem equally unlikely to fly with the "strict bodily autonomy" crowd: increased insurance premiums or exception clauses in policies in order to keep expenses reined in for the rest of the policy holders/taxpayers who aren't using their strict autonomy in a way that adversely affects others.
While it's fine to conceptually discuss these decisions in a vacuum where it only affects the individual, in real life application, these decisions have impacts outside the individual in almost every case, which fundamentally shift the discussion.
I struggle with this line of thinking because there are so many legal things people can do to increase their probability of being a burden in the national healthcare system. Alcohol, junk food, working too much, gambling too maybe. I can't wrap my head around a system that would be "fair" and not fall into a black mirror episode dystopian "good citizen" points system. I'd rather just pay more than my fair share, knowingly subsidise people who make bad choices, and not live in the dystopian society.
Theres a separate argument about the drugs increasing crime probability that I also don't buy entirely. Those crimes are crimes already, so making these other "precrimes" also crimes seems a bit weird - not to mention wildly ineffective at reducing harm or use of the substances in question. I'm sure we can identify books and films that increase future criminal probability too.
Bodily autonomy does hold some water for me as an argument, but for me it's more about finding a way to minimise societal harm while maximally hurting the businesses profiting from these dark economies we have created through prohibition. But this brings up another round of tough questions: do we do this for all substances? Forever? Is this really the path of least societal harm? (I honestly don't know)
Then you charge people with the crimes they've committed. You hold people accountable for the choices they've made. It's quite simple, in my opinion.